scholarly journals Implementing the Chronic Disease Self Management Model in Vulnerable Patient Populations: Bridging the Chasm through Telemedicine

10.5772/13632 ◽  
2011 ◽  
Author(s):  
Cardozo Lavoisier ◽  
Steinberg Joel ◽  
Cardozo Shaun ◽  
Vikas Veeranna ◽  
Deol Bibban ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Management Model ◽  
Self Management ◽  
Vulnerable Patient

Using S’ANT for Facilitating Superior Understanding of Key Factors in the Design of a Chronic Disease Self-Management Model

2011 ◽  
pp. 223-233 ◽  
Author(s):  
Nilmini Wickramasinghe ◽  
Rajeev K. Bali ◽  
Steve Goldberg
Keyword(s):  
Social Network ◽  
Chronic Disease ◽  
Social Network Analysis ◽  
Network Analysis ◽  
Network Theory ◽  
Actor Network Theory ◽  
Management Model ◽  
Self Management ◽  
Key Factors ◽  
Actor Network

The S’ANT approach (Wickramasinghe and Bali, 2009) - namely the incorporation of Actor-network Theory and Social Network Analysis as proposed by Wickramasinghe and Bali 2009 in order to support a network centric healthcare solutions is proffered in the following as an appropriately rich lens of analysis in the context of the development of a chronic disease self-management model.

The S'ANT Approach to Facilitate a Superior Chronic Disease Self-Management Model

2009 ◽  
Vol 1 (4) ◽  
pp. 21-34 ◽  
Author(s):  
Nilmini Wickramasinghe ◽  
Rajeev K. Bali ◽  
Steve Goldberg
Keyword(s):  
Social Network ◽  
Chronic Disease ◽  
Network Analysis ◽  
Network Theory ◽  
Diabetes Management ◽  
Actor Network Theory ◽  
Management Model ◽  
Self Management ◽  
Pervasive Technology ◽  
Technology Solution

Diabetes is one of the leading chronic diseases and its prevalence continues to rise exponentially. The goal of this article is to present the case for the application of a pervasive technology solution in the form of a wireless-enabled mobile phone to facilitate superior diabetes management. In so doing, we highlight the need for employing the S’ANT approach (Wickramasinghe and Bali, 2009) - namely the incorporation of Actor-network Theory and Social Network Analysis - in order to support a network centric healthcare solution.

scholarly journals Lessons learned implementing and managing the DIVERT-CARE trial: practice recommendations for a community-based chronic disease self-management model

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Darly Dash ◽  
Connie Schumacher ◽  
Aaron Jones ◽  
Andrew P. Costa
Keyword(s):  
Chronic Disease ◽  
Home Care ◽  
Management Practices ◽  
Pragmatic Trial ◽  
Lessons Learned ◽  
Management Model ◽  
Self Management ◽  
Local Context ◽  
Trial Management ◽  
Community Based

Abstract Background Chronic disease management models of care provide an opportunity to assist home care clients to manage their disease burden. However, pragmatic trial management practices and lessons learned from such models are poorly illustrated in the literature. Methods We describe the processes of implementing a community-based cardiorespiratory self-management model, known as DIVERT-CARE, across the home care programs of three health regions in Canada. The DIVERT-CARE model is a multi-component complex intervention that identifies home care clients at the highest risk of deterioration and provides them with resources and capacity to manage their conditions. We conducted a retrospective analysis of baseline participant characteristics, needs assessments, reviewed findings from site visits and a national workshop with study partners, and examined other study documentation. Results Three home care regions in Canada participated in the study. A robust and data-driven review of each site was necessary to understand the local context, home care caseloads, structure of local systems, and intensity of resources, which influenced study processes. The creation of an intervention framework highlighted the need to adapt the intervention in a way that was sensitive to the local context while maintaining intervention outcomes. Conclusion Our detailed review showcases the relevant activities and on-the-ground steps needed to manage and conduct a multi-site pragmatic trial in home care. This example can help other researchers in implementing multi-disciplinary and multi-component care models for practice-based research.

Integration of assistive technology to support self management of chronic disease

2009 ◽  
Author(s):  
H. Zheng ◽  
C.D. Nugent ◽  
P.J. McCullagh ◽  
W.P. Burns ◽  
S. Alexander ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Assistive Technology ◽  
Self Management

scholarly journals Effectiveness of an eHealth self-management tool for older adults with multimorbidity (KeepWell): protocol for a hybrid effectiveness–implementation randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e048350
Author(s):  
Monika Kastner ◽  
Julie Makarski ◽  
Leigh Hayden ◽  
Jemila S Hamid ◽  
Jayna Holroyd-Leduc ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Disease ◽  
Randomised Controlled Trial ◽  
Disease Management ◽  
Chronic Conditions ◽  
Controlled Trial ◽  
Management Tool ◽  
Self Management ◽  
Plain Language ◽  
Randomised Controlled

IntroductionIn response to the burden of chronic disease among older adults, different chronic disease self-management tools have been created to optimise disease management. However, these seldom consider all aspects of disease management are not usually developed specifically for seniors or created for sustained use and are primarily focused on a single disease. We created an eHealth self-management application called ‘KeepWell’ that supports seniors with complex care needs in their homes. It incorporates the care for two or more chronic conditions from among the most prevalent high-burden chronic diseases.Methods and analysisWe will evaluate the effectiveness, cost and uptake of KeepWell in a 6-month, pragmatic, hybrid effectiveness–implementation randomised controlled trial. Older adults age ≥65 years with one or more chronic conditions who are English speaking are able to consent and have access to a computer or tablet device, internet and an email address will be eligible. All consenting participants will be randomly assigned to KeepWell or control. The allocation sequence will be determined using a random number generator.Primary outcome is perceived self-efficacy at 6 months. Secondary outcomes include quality of life, health background/status, lifestyle (nutrition, physical activity, caffeine, alcohol, smoking and bladder health), social engagement and connections, eHealth literacy; all collected via a Health Risk Questionnaire embedded within KeepWell (intervention) or a survey platform (control). Implementation outcomes will include reach, effectiveness, adoption, fidelity, implementation cost and sustainability.Ethics and disseminationEthics approval has been received from the North York General Hospital Research and Ethics Board. The study is funded by the Canadian Institutes of Health Research and the Ontario Ministry of Health. We will work with our team to develop a dissemination strategy which will include publications, presentations, plain language summaries and an end-of-grant meeting.Trial registration numberNCT04437238.

scholarly journals A qualitative study of home care client and caregiver experiences with a complex cardio-respiratory management model

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Connie Schumacher ◽  
Darly Dash ◽  
Fabrice Mowbray ◽  
Lindsay Klea ◽  
Andrew Costa
Keyword(s):  
Health Service ◽  
Qualitative Study ◽  
Home Care ◽  
Therapeutic Relationship ◽  
Service Use ◽  
Management Model ◽  
Health Service Use ◽  
Self Management ◽  
Home Based ◽  
Respiratory Management

Abstract Background Home care clients are typically older and have some degree of medical, physical, cognitive or social conditions that require formal or informal support to promote healthy aging in the community. Home care clients contribute a significant proportion of health service use, including emergency department visits. The DIVERT-CARE trial introduced a cardio-respiratory management model to improve client motivation, symptoms and rates of unwarranted health service use. Our objective was to explore the perceptions and experiences of individuals who participated in the DIVERT-CARE self-management support and education intervention. Methods A qualitative study was nested within a pragmatic randomized control trial and conducted following a 15-week multi-component cardio-respiratory intervention. A phenomenological descriptive design was employed using thematic analysis. Post-intervention, clients and their caregivers were invited to participate in a semi-structured telephone interview. Interview questions were designed to elicit the experience with the intervention components. Results A total of 29 interviews were completed from June 2018 to March 2020 from participants in Ontario, Newfoundland, and British Columbia. Three themes were identified; self-care trajectory and burden of responsibility, learning and behaviour change, and feeling connected pre-emptively to care providers, the information and medical advice, and connection through the therapeutic relationship. Conclusions Home care clients experience unique challenges in managing cardio-respiratory related chronic disease. Home-based interventions fostered a therapeutic relationship of connectedness while equipping clients with necessary knowledge and skills. These results inform recommendations for community nursing, and home-based self-management supports for older community-residing individuals.

Self-management factors associated with quality of life among women with endometriosis: a cross-sectional Australian survey

2020 ◽  
Author(s):  
Rebecca O’Hara ◽  
Heather Rowe ◽  
Jane Fisher
Keyword(s):  
Quality Of Life ◽  
Chronic Disease ◽  
Disease Management ◽  
Self Efficacy ◽  
Chronic Disease Management ◽  
Self Management ◽  
Cross Sectional ◽  
Female Population ◽  
Management Factors

Abstract STUDY QUESTION What self-management factors are associated with quality of life among women with endometriosis? SUMMARY ANSWER Greater self-efficacy was associated with improved physical and mental quality of life. WHAT IS KNOWN ALREADY Women with endometriosis have an impaired quality of life compared to the general female population. However, most studies have investigated quality of life in a hospital or clinic setting rather than a community setting and the association between self-management factors and quality of life have not, to date, been investigated. STUDY DESIGN, SIZE, DURATION A cross-sectional, population-based online survey was performed, which was advertised through women’s, community and endometriosis-specific groups. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 620 women completed the survey for this study. Mental and physical quality of life was assessed using the standardized SF36v2 questionnaire. Self-management factors included self-efficacy, partners in health (active involvement in managing the condition) and performance of self-care activities. Treatment approaches included the use of hormonal treatment, pain medications and complementary therapies and whether the participant had a chronic disease management plan. Hierarchical regression analyses were used to examine whether self-management and treatment factors were associated with quality of life. MAIN RESULTS AND THE ROLE OF CHANCE Both physical and mental quality of life were significantly lower among women with endometriosis compared to the mean scores of the general Australian female population (P < 0.001). Physical quality of life was positively associated with income sufficiency (P < 0.001) and greater self-efficacy (P < 0.001), but negatively associated with age (P < 0.001), pain severity (P < 0.001), use of prescription medications (P < 0.001), having a chronic disease management plan (P < 0.05) and number of self-care activities (P < 0.05). Mental quality of life was positively associated with being older (P < 0.001), partnered (P < 0.001), having a university education (P < 0.05), increasing self-efficacy (P < 0.001) and higher partners in health scores (P < 0.001). LIMITATIONS, REASONS FOR CAUTION Results are derived from a cross-sectional study and can only be interpreted as associations not as causal relationships. The sample was more educated, more likely to speak English and be born in Australia than the general Australian female population of the same age, which may influence the generalizability of these results. WIDER IMPLICATIONS OF THE FINDINGS This study investigated a knowledge gap by investigating quality of life of women with endometriosis in a large community sample. Self-efficacy was significantly associated with both physical and mental quality of life. Supporting women with endometriosis to improve self-efficacy through a structured chronic disease management programme may lead to improvements in this aspect of wellbeing. STUDY FUNDING/COMPETING INTEREST(S) R.O. undertook this research as part of her PhD at Monash University, which was supported by an Australian Government Research Training Program Stipend. J.F. is the Finkel Professor of Global Public Health, which was supported by the Finkel Family Foundation. There are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER NA.

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